U.S. patent number 6,406,440 [Application Number 09/745,664] was granted by the patent office on 2002-06-18 for specimen retrieval bag.
This patent grant is currently assigned to Ethicon Endo-Surgery, Inc.. Invention is credited to David Stefanchik.
United States Patent |
6,406,440 |
Stefanchik |
June 18, 2002 |
Specimen retrieval bag
Abstract
In accordance with the present invention there is provided a
surgical instrument for the removal of biological material through
an opening within a patient, wherein biological material being
larger than the opening within the patient. The surgical instrument
includes a specimen retrieval bag having at least one wall. The
specimen retrieval bag has an open end, a closed end and a
longitudinal axis extending therebetween, wherein the open end is
for receiving biological materials therein. The instrument further
includes at least one material transfer member attached to the wall
adjacent to the open end. The material transfer member extends
radially from the wall and is in fluid communication with the bag.
Wherein when the open end of the bag is removed from the patient
through the opening and the material transfer member is at least
partially removed therethrough, a portion of the biological
material moves from a portion of the bag within the patient to a
portion of the material transfer member outside of the patient to
reduce the size of the biological material within the patient.
Inventors: |
Stefanchik; David (Mason,
OH) |
Assignee: |
Ethicon Endo-Surgery, Inc.
(Cincinnati, OH)
|
Family
ID: |
24997700 |
Appl.
No.: |
09/745,664 |
Filed: |
December 21, 2000 |
Current U.S.
Class: |
600/562;
604/328 |
Current CPC
Class: |
A61B
17/00234 (20130101); A61B 2017/00287 (20130101) |
Current International
Class: |
A61B
17/00 (20060101); A61B 010/00 () |
Field of
Search: |
;600/562,543,564
;604/327,328 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Shaver; Kevin
Assistant Examiner: Wingood; Pamela L
Attorney, Agent or Firm: Garner; Dean
Claims
What is claimed is:
1. A surgical instrument for the removal of biological material
through an opening within a patient, the biological material being
larger than the opening within the patient, the surgical instrument
comprising:
a. a specimen retrieval bag having at least one wall, said specimen
retrieval bag having an open end, a closed end and a longitudinal
axis extending therebetween, said open end for receiving biological
materials therein; and
b. at least one material transfer member attached to said wall
adjacent to said open end, said material transfer member extending
radially from said wall and being in fluid communication with said
bag, wherein when said open end of said bag is removed from the
patient through the opening and said material transfer member is at
least partially removed therethrough, a portion of the biological
material moves from a portion of said bag within the patient to a
portion of said material transfer member outside of said patient to
reduce the size of the biological material within the patient.
2. The surgical instrument of claim 1 wherein said material
transfer member is at least one expandable element near to said
open end.
3. The surgical instrument of claim 2 wherein said at least one
expandable element is a bellows.
4. The surgical instrument of claim 1 wherein said wall is
fabricated from a polymeric material.
5. The surgical instrument of claim 4 wherein said polymeric
material is Polyurethane.
6. The surgical instrument of claim 1 wherein said specimen
retrieval bag is tapered, said specimen retrieval bag larger at
said open end and smaller at said closed end.
7. The surgical instrument of claim 1 wherein said specimen
retrieval bag has a drawstring for closing the open end of the
specimen retrieval bag.
8. A surgical instrument for the removal of biological material
through an opening within a patient, the biological material being
larger than the opening within the patient, the surgical instrument
comprising:
a. a specimen retrieval bag having at least one wall, said specimen
retrieval bag having an open end and a closed end, said open end
for receiving biological materials therein; and
b. at least one outwardly disposed blister on said wall, wherein
when said specimen retrieval bag and said blister are partially
removed from the patient through the opening, a portion of the
biological material moves within said blister moving said material
from a portion of said bag within the patient to a portion of said
bag outside of said patient to reduce the size of the biological
material within the patient.
9. The surgical instrument of claim 8 wherein said wall is
fabricated from a polymeric material.
10. The surgical instrument of claim 9 wherein said polymeric
material is Polyurethane.
11. The surgical instrument of claim 8 wherein said specimen
retrieval bag is tapered, said specimen retrieval bag larger at
said open end and smaller at said closed end.
12. The surgical instrument of claim 8 wherein said specimen
retrieval bag has a drawstring for closing the open end of the
specimen retrieval bag.
Description
FIELD OF THE INVENTION
The present invention relates, in general, to surgical instruments
for retrieving tissue and, more particularly, to endoscopic
surgical instruments such as pouches or specimen retrieval bags for
the removal of tissue through a small incision.
BACKGROUND OF THE INVENTION
Endoscopic surgery is a procedure wherein surgery is performed
through a series of small openings or incisions in a patient. This
type of surgery reduces or eliminates the need for large incisions
and has changed some of the major open surgical procedures such as
gall bladder removal to simple outpatient surgery. Consequently,
the patient's recovery time has changed from weeks to days. These
types of surgeries are used for repairing defects or for the
removal of diseased tissue or organs from areas of the body such as
the abdominal cavity.
Of interest is the removal or excision of biological material or
tissue from the body through a small incision or small natural
orifice. Tissue can have many types or forms but fall into three
general categories: firm tissue such as muscle and solid tumors,
soft tissues such as liver, and fluid filled tissues such as a
cyst, a gall bladder, a spleen, or an inflamed appendix. Some
tissue can be a mix of multiple categories. For example, an
inflamed gall bladder can be a mix of hardened gallstones, fluids
such as bile and pus, and an outer covering of firm tissue.
One challenge that exists with minimally invasive surgery is the
removal of excised tissue through an opening in the body. A
time-honored solution is the manual cutting of the large tissue
mass into small pieces that can fit through the incision. However,
with this process, fragments of tissue can be dropped and fluids
can be spilled into the body cavity. This is serious if the excised
tissue is cancerous or infected as this can lead to the seeding and
re-spreading of cancer or the spreading of inflammation to healthy
tissue.
In answer to the above challenges, surgical pouches or specimen
retrieval bags were developed. The specimen retrieval bags are
placed endoscopically into an inner cavity of the body, the bags
are opened, and the diseased tissue is placed within. The specimen
retrieval bags are closed to surround and contain the tissue and
fluids within. Thus, the closed specimen retrieval bag prevents the
migration of tissue and fluids from the bag into the inner cavity
of the body. Once the diseased tissue is placed into the open
specimen retrieval bag, the bag is closed and pulled from the inner
cavity through an incision or trocar. Drawstrings are typically
used to close the specimen retrieval bag in the body and to draw
the bag out of the opening in the body. Surgical instruments of
this type are described in U.S Pat. No. 5,465,731 by Bell et al.
and 5,465,732 by Tovey et al. which are incorporated herein by
reference.
Morcellation instruments were also developed that can be used in
conjunction with the specimen retrieval bags to chop or dissect
large tissue masses within the specimen retrieval bags. When using
a morcellation instrument, tissue is placed into the open specimen
retrieval bag and the bag opening is partially drawn out of the
body, leaving the tissue within the body cavity. Next, the bag is
opened and the morcellator is inserted into the bag and into the
portion of the bag still within the body cavity to morcellate the
tissue. Suction can be used to remove morcellated tissue. A RF
morcellation instrument and method of use are described in U.S.
Pat. No. 5,957,884 by Michael D. Hooven and a description of
morcellation is found in U.S. Pat. No. 5,465,731 by Bell et al. and
U.S. Pat. No. 5,465,732 by Tovey et al.
Whereas this method of removing tissue from the body does work, it
was awkward for the surgeon to hold the bag open while morcellating
and suctioning to remove pieces of tissue. If care is not
exercised, the bag can be punctured or the spillage of fluids or
and tissue can occur. Additionally, costly, sophisticated specimen
retrieval bags are required that are resistant to cutting from the
mechanical morcellator blades or RF energy.
U.S. Pat. No. 5,681,324 by Kammerer et al. teaches that a square
bottomed pouch (or specimen retrieval bag) enables the tissue
specimen to lie across the bottom of the pouch and to impede the
removal of the tissue through a trocar site (or incision). More
importantly, Kammerer et al. also teaches that a tapered-bottomed
pouch solves the square-bottomed pouch problem by aligning the
tissue and makes it possible to remove tissue from the body cavity
without enlarging the incision. Additionally, the tapered pouch
shape reduces the amount of trapped air and reduces the ballooning
effect when the pouch is closed and reduces the stress exerted on
the pouch and abdominal wall tissue (caused by pulling the pouch
through the trocar site or incision). Whereas the tapered pouch did
indeed facilitate the removal of tissue, there is room for
additional solutions to this problem, particularly when fluids are
present within the specimen retrieval bag or within the tissue
placed therein.
What is needed is a specimen retrieval bag that offers all of the
advantages listed above by providing a pouch or specimen retrieval
bag that is easy to remove from the body. Additionally, it would be
advantageous to provide an improved specimen retrieval bag that
makes it easier for a surgeon to remove a specimen retrieval bag
that contains fluids or materials such as chunked or morcellated
tissue that that flow under pressure. Presently, there are no known
specimen retrieval bags that can provide the surgeon with the
improvements and benefits described above.
SUMMARY OF THE INVENTION
In accordance with the present invention there is provided a
surgical instrument for the removal of biological material through
an opening within a patient, wherein biological material being
larger than the opening within the patient. The surgical instrument
includes a specimen retrieval bag having at least one wall. The
specimen retrieval bag has an open end, a closed end and a
longitudinal axis extending therebetween, wherein the open end is
for receiving biological materials therein. The instrument further
includes at least one material transfer member attached to the wall
adjacent to the open end. The material transfer member extends
radially from the wall and is in fluid communication with the bag.
Wherein when the open end of the bag is removed from the patient
through the opening and the material transfer member is at least
partially removed therethrough, a portion of the biological
material moves from a portion of the bag within the patient to a
portion of the material transfer member outside of the patient to
reduce the size of the biological material within the patient.
BRIEF DESCRIPTION OF THE DRAWINGS
The novel features of the invention are set forth with
particularity in the appended claims. The invention itself,
however, both as to organization and methods of operation, together
with further objects and advantages thereof, may best be understood
by reference to the following description, taken in conjunction
with the accompanying drawings in which:
FIG. 1 illustrates an isometric view of a cross section of the
abdominal wall and an improved specimen retrieval bag mounted on a
specimen retrieval bag instrument, the improved specimen retrieval
bag receiving a gall bladder from a surgical grasping instrument
within the abdominal cavity;
FIG. 2 illustrates an enlarged isometric view of a distal end of
the improved specimen retrieval bag instrument of FIG. 1 prior to
the receipt of the gall bladder, wherein a novel blister feature
extends from a wall of an improved specimen retrieval bag;
FIG. 3 is a top view of the improved specimen retrieval bag of FIG.
2, wherein the blister features extend outwardly from the walls of
the improved specimen retrieval bag;
FIG. 4 is an is an enlarged isometric view of a prior art specimen
retrieval bag wherein the prior art specimen retrieval bag is open
and a gall bladder and fluid are placed therein;
FIG. 5 illustrates a cross-sectional view wherein the opening of
the prior art specimen retrieval bag of FIG. 4 is being pulled
through an incision within the abdominal wall and the gall bladder
and fluid are ballooning the prior art specimen retrieval bag
within an abdominal cavity;
FIG. 6 a cross-sectional view of the abdominal wall and the prior
art specimen retrieval bag of FIG. 5, wherein the prior art
specimen retrieval bag is being pulled through an incision and the
forces exerted upon the prior art bag are shown;
FIG. 7 a cross-sectional view of the abdominal wall and the
improved specimen retrieval bag of FIG. 2, wherein the improved
specimen retrieval bag is being pulled through an incision with a
gall bladder and fluid within, and the forces exerted upon the
improved specimen retrieval bag are shown;
FIG. 8 is a cross sectional view of the of the abdominal wall and
the improved specimen retrieval bag of FIG. 7, wherein the improved
specimen retrieval bag is being pulled through an incision, and
fluids are flowing from a lower portion of the specimen retrieval
bag into an upper portion of the blisters of the improved specimen
retrieval bag to reduce the size of the lower portion;
FIG. 9 is a cross sectional view of the of the abdominal wall
wherein a first alternate embodiment of the improved specimen
retrieval bag of FIG. 5 is shown;
FIG. 10 is a cross sectional view of the of the abdominal wall
wherein a second alternate embodiment of the improved specimen
retrieval bag of FIG. 5 is shown.
DETAILED DESCRIPTION OF THE INVENTION
The present invention relates, in general, to surgical instruments
for retrieving excised tissue from a patient and, more
particularly, to endoscopic surgical instruments such as pouches or
specimen retrieval bags for the removal of tissue through a small
incision.
The Present Invention Instrument
In FIG. 1, the present invention is an improved specimen retrieval
bag 25 shown removably attached to a distal end 41 of a deployment
instrument 40. The deployment instrument 40 is shown inserted into
an abdominal cavity 45 of a patient through a first incision 47
within a patient's abdominal wall 46. A trocar 55 is inserted into
a second incision 48 within the abdominal wall 46 and has a
grasping instrument 60 inserted within a cannula 56 (not shown) of
the trocar 55. Alternately, if desired, the improved specimen
retrieval bag 25 can be drawn into the cannula 56 of the trocar 55
(not shown). Grasping instrument 60 is shown gripping a gall
bladder 70 over an opening 26 of the improved specimen retrieval
bag 25 just prior to placement of the gall bladder 70 therein.
FIGS. 2 and 3 are enlarged views of the improved specimen retrieval
bag 25 of the present invention releasably attached to a distal end
41 of the deployment instrument 40. Improved specimen retrieval bag
25 has two opposing walls 27a and 27b that when joined form a
single wall, hereafter referred to as wall 27. The wall 27 is
formed from at least one layer of a resilient or flexible material,
and has an opening 26 shown in the open position, and a bottom 31.
A material transfer member or blister 28 extends outwardly from
each wall 27 generally perpendicular to the opening 26 of the
improved specimen retrieval bag 25. In FIG. 2 the far side blister
28 is removed for clarity. Channels 29 are located in the improved
specimen retrieval bag 25, one along each side of the opening 26.
Each channel 29 slidably receives one of a pair of flexible arms 42
extending from the distal end 41 of the deployment instrument 40.
When the surgeon desires to detach the improved specimen retrieval
bag 25 from the deployment instrument 40, the pair of flexible arms
42 withdraw into the deployment instrument 40 to release the
improved specimen retrieval bag 25. A drawstring 30 is threaded
through each of the channels 29 and extends into the deployment
instrument 40.
Improved specimen retrieval bag 25 of the present invention is
formed from a pair of opposed walls 27 that are made of at least
one layer of elastomeric or polymeric material. The walls 27 are
tapered to facilitate removal of the improved specimen retrieval
bag 25 from the first incision 47. Walls 27 are constructed from at
least one layer of an elastomeric or polymeric material such as
Polyurethane, Polyethylene, Polypropylene, Silicone, Vinyl, or
Teflon. Multiple layer construction of the walls 27 are common and
can incorporate flexible metal meshes, thermoformed plastic meshes,
fabrics, or Kevlar for reinforcement. As shown, walls 27 are formed
from flat sheets of Polyurethane and are cut into a desired shape
with sides 37 tapered as shown. Blister 28 is formed into a wall 27
by the application of heat, pressure, impact, ultrasonic energy or
any combination thereof. Blisters 28 are formed in the wall 27 such
that when the walls 27 are loaded in tension such as in the
vertical direction at the opening 26 and bottom 31, the stresses
travel within in the flat portions of the walls 27 and around the
blisters 28. This is somewhat analogous to the manner in which
stresses travel around a hole in a part when the part is in
tension. The opposed walls 27 are orientated with the blisters 28
extending outwardly as shown, and the walls 27 are sides 37 are
glued, heated, or ultrasonically welded together along the sides 37
and bottom 31. Alternately, the Improved specimen retrieval bag 25
can be molded or dip formed into a desired configuration.
Prior Art Instrument Description
FIG. 4 illustrates a prior art retrieval bag 80. Some of the
elements are common to both the prior art bag 80 and the improved
specimen retrieval bag 25 bag described previously. When like
elements, or nearly identical elements exist, they will have the
same element numbers, general descriptions, and generally the same
functions. Likewise, generally similar patient anatomy or bag
contents will have the same element numbers and descriptions.
As shown in FIG. 4, prior art retrieval bag 80 contains contents
72, an excised gall bladder 70 and fluid 71. The excised gall
bladder 70 has been placed into an opening 26 of the prior art
retrieval bag 80 and fluid 71 has leaked from the gall bladder 70.
Fluid 71 from the gall bladder 70 excision consists of bile, blood,
or pus, and any combination thereof. Prior art retrieval bag 80 is
attachable (not shown) to the deployment instrument 40 (FIG. 1) in
the manner previously described for the improved specimen retrieval
bag 25.
Channels 29 are provided surrounding the opening 26 of the prior
art retrieval bag 80 for the reception of the flexible arms 42
extending from the deployment instrument 40 (FIG. 1). Drawstring 30
is placed into the channels 29 for closing the opening 26 of prior
art retrieval bag 80. Prior art retrieval bag 80 is generally
formed from a pair of opposed walls 27 that are made of at least
one layer of the materials described above for the improved
specimen retrieval bag 25. Sides 37 and bottom 31 are welded,
attached or glued together. The sides 37 are not tapered.
Prior Art Instrument--Method of Use and Force Analysis during
Removal
FIGS. 5 and 6 illustrate the method of pulling the prior art
retrieval bag 80 containing contents 72 through an incision, and
the forces involved in pulling the prior art retrieval bag 80 and
the contents 72 through the incision. The description of the method
of use of the prior art retrieval bag 80 is provided so that the
reader can better understand novel advantages provided with the
improved specimen retrieval bag 25 of the present invention which
will be discussed in detail below.
As shown in FIGS. 5 and 6, the prior art retrieval bag 80 is being
withdrawn from the abdominal cavity 45 of a patient. Prior to the
view of FIGS. 5 and 6, the following steps have occurred. First,
the prior art retrieval bag 80 has been placed into the patient's
abdominal cavity on a deployment instrument 40, and a fluid filled
gall bladder 70 is placed therein. The prior art retrieval bag 80
is then closed, released from the deployment instrument 40, and the
deployment instrument 40 is then removed from the first incision
(not shown).
Next, as shown in FIGS. 5 and 6, an upward tensile force F is
applied to the drawstrings 30. This force F is pulling the prior
art retrieval bag 80 and contents 72 through the first incision 47
within abdominal wall 46. As shown, the partially removed prior art
retrieval bag 80 has an upper columnar shaped portion, henceforth
referred to as column 32, which is under tension from force F and
extends from the first incision 47. Prior art retrieval bag 80 also
has a lower spherical shaped portion referred to as balloon 33
which assumes the spherical shape from the compression of the
contents 72 therein. Balloon 33 is located within the abdominal
cavity 45 just below the first incision 47.
FIG. 6 is a cross section of the prior art retrieval bag 80 of FIG.
5 showing the balance of physical forces therein as the prior art
retrieval bag 80 and contents 72 (gall bladder 70 and fluid 71) are
being pulled through the first incision 47. Fluids 71 are present
within the contents 72 and are indicated by dashed horizontal
lines. The walls 27 of the prior art retrieval bag 80 are replaced
with arrows to indicate tensions found within the walls 27 from the
forces exerted thereon. The tension arrows will also be referred to
as walls 27. As shown in FIG. 6, the upwards motion of the prior
art retrieval bag 80 brings the balloon 33 into contact with an
inner side of the abdominal wall 46 at first incision 47 and biases
the walls 27 of column 32 inwardly. This contact produces a
downward and inward abdominal wall contact force F.sub.TISSUE on
the walls 27 of the balloon. The abdominal wall contact force
F.sub.TISSUE opposes the tension force F and places the walls 27 of
the column 32 under tension as indicated by tension arrows
T.sub.2.
The upwardly motion of prior art retrieval bag 80 and the inwardly
and downwardly abdominal wall contact force F.sub.TISSUE squeezes
the contents 72 within the balloon 33. As the prior art retrieval
bag 80 is pulled through the first incision 47, the balloon 33 gets
smaller and the walls 27 of the balloon 33 constrict the contents
72 of the balloon 33 inwardly. The constricting walls 27 of the
balloon 33 are opposed by the incompressible contents 72 which
exert radially outward pressure vectors P.sub.1. on the walls 27 of
balloon 33, and the force F creates a tension T.sub.1, within the
walls 27 of the balloon 33.
The constricting walls 27 force fluids 71 to flow from balloon 33
into the column 32. The opening 26 of the prior art retrieval bag
80 is not fully sealed and air leaks from the opening 26 enabling
the fluids 71 to rise within the column 32. The weight of the
column of fluids 71 push outwardly with a force P.sub.22 on the
walls 27 of the column 32 and try to bulge the walls 27 above the
abdominal wall 46 outwardly. However, the reader is advised to note
that the tension forces T.sub.2 within the walls 27 of the column
32 are higher than the fluid force P.sub.22 and the walls remain in
the columnar shape of column 32. Thus, tension forces T.sub.2
control the volume within the column 32. Fluid 71 can rise into the
limited volume defined within the column 32 of the prior art
retrieval bag 80 until all of the air flows out of gaps within the
opening 26, and the fluid 71 reaches the opening 26. At this point,
if the balloon 33 is small enough, the balloon 33 slips through the
first incision 47 and the prior art retrieval bag 80 is
extracted.
If the balloon 33 is too large to fit through the incision and the
column 32 is filled with fluid 71, continuing to draw the prior art
retrieval bag 80 out of the first incision 47 can force fluid 71
out of the opening 26 when it is closed. This spillage of fluids 71
complicates the surgery and can require the use of a suction
instrument to remove the fluids 71 seeping from the opening 26. In
some cases it is necessary to re-open the opening 26 and to use
suction or forceps to extract some of the contents 72 therefrom. In
some cases, it can be necessary to increase the length of the first
incision 47 to remove the prior art retrieval bag 80, or to use
scissors or a morcellator on the contents 72 to facilitate removal
of the prior art retrieval bag 80.
Improved Instrument--Method of Use and Force Analysis during
Removal
FIGS. 7 and 8 are cross-sections of the improved specimen retrieval
bag 25 of the present invention being pulled or removed from the
first incision 47. These FIGS. illustrate the method of use of the
present invention and the balance of forces between the improved
specimen retrieval bag 25, the abdominal wall and the contents 72
therein. The reader is advised to review the above sections
describing prior art specimen retrieval bag 80 for comparisons.
Prior to the view of FIGS. 7 and 8, the improved specimen retrieval
bag 25 on the deployment instrument 40 was placed into the
abdominal cavity 45 (FIG. 1) and a gall bladder 70 was placed
therein. The improved specimen retrieval bag 25 was closed, and
then released from the deployment instrument 40. Finally, the
deployment instrument 40 was removed from the first incision
47.
Next, an upward tensile force F is applied to draw the improved
specimen retrieval bag 25 and contents 72 consisting of gall
bladder 70 and fluid 71 through the first incision 47 and out of
the patient. FIG. 7 shows a cross section of the improved specimen
retrieval bag 25 (taken across the blisters 28) as it is being
partially drawn upwards through the first incision 47 by tensile
force F.
The cross section of FIG. 7 is taken across the blisters 28 of the
improved specimen retrieval bag 25 and shows the forces involved
therein. As described previously, the walls 27 and the blisters 28
are designed such that when the walls 27 are placed under tension
(from the force F), the tensile forces travel within the walls 27
and around the blisters 28. Thus, the upper force F exerts tension
on the walls 27 and not on the blisters 28. In FIG. 7 walls 27 are
outlined by the tension arrows T.sub.3 and T.sub.4. The blisters 28
are not under tension from the force F.
The contents 72 of the improved specimen retrieval bag 25 are being
compressed or constricted within the balloon 33 and exert an
outwards force P.sub.3 on the portion of the walls 27 and blister
28 of the balloon 33. In FIG. 7, the contents 72 consist of gall
bladder 70 and fluid 71. The upwards motion of the improved
specimen retrieval bag 25 constricts the contents 70 of the balloon
33 and forces the fluid 71 to rise into the portion of the improved
specimen retrieval bag 25 extending above the incision 47. The
constriction compresses the contents 72 within the balloon 33 and
the contents 72 exert a radially outwards force P.sub.3 on the
portion of the walls 27 and blister 28 of the balloon 33. This
outward pressure has tensioned the walls 27 of the balloon 33 as
indicated by the tension arrows T.sub.3, and has expanded blisters
28 outwardly from the balloon 33.
As the improved specimen retrieval bag 25 is advanced upwardly by
force F, fluid 71 moves upwardly from the constricted balloon 33
and into the column 32, expanding the non-tensioned portions NT of
the blisters 28 outwardly outside of the incision 47.This movement
of fluids 71 into the non-tensioned portions NT of the blisters 38
reduces the size of the contents of the balloon 33, enabling the
improved specimen retrieval bag 25 to be pulled farther out of the
first incision 47. As more of the improved specimen retrieval bag
25 moves out of the body, more the non-tensioned portions NT of the
blisters 38 emerge from the first incision 47 and more fluids 71
can move upwardly from the balloon 33 into the non-tensioned
portions NT of the blisters 28. This fluid transfer process
continues until the improved specimen retrieval bag 25 and contents
72 are easily extracted from the patient.
FIG. 8 is a cross-section of the improved specimen retrieval bag 25
across vertical axis B--B and the blisters 28 showing an embodiment
of the method steps of using the present invention to remove a
fluid filled organ such as a gall bladder 70. Gall bladder 70 is
first placed into the improved specimen retrieval bag 25 and a cut
74 is placed into the gall bladder 70 to release the fluids 71
within. Next, the improved specimen retrieval bag 25 is closed, and
the improved specimen retrieval bag 25 is pulled out of the first
incision 47. As shown, pulling the improved specimen retrieval bag
25 through the first incision 47 compresses the gall bladder 70,
squeezing fluids 71 from the cut 74. The flow of fluids 71 from the
gall bladder 70 reduces the size of the organ and makes it easier
to draw the organ through the first incision 47. As described
above, the fluids 71 flow easily from the cut 74 within the
squeezed gall bladder 70, into the column 32 and into the
non-tensioned portions NT of the blisters 28. This flow of fluids
71 into the non-tensioned portions NT of the blisters 28 reduces
the size of the balloon 33, and facilitates the removal of the
improved specimen retrieval bag 25 from the patient.
FIGS. 9 and 10 illustrate alternate embodiments of the improved
specimen retrieval bag 25. FIG. 9 shows an alternate embodiment of
improved specimen retrieval bag 25 bag without blisters 28 but
having an expandable element located adjacent to the opening 26. As
shown, the expandable element is a bellows 34 that easily expands
outwardly when pressurized. As the bellows 34 expands outwardly,
fluids flow from the balloon 33, into the column 32 and into the
bellows 34. Alternately, placing an elastomeric panel placed within
the walls 27 of the improved specimen retrieval bag 25 will also
meet the intent of the alternate embodiment.
FIG. 10 shows yet another alternate embodiment of the improved
specimen retrieval bag 25 having an alternate embodiment of the
transfer portion for the transport of fluids out of the patient.
This alternate transfer portion has a hollow fluid passage 35 for
the transfer of fluid from the balloon 33 into a receptacle 36
located outside of the abdominal wall 46. Hollow fluid passage 35
has a first end and a second end. Pulling the balloon 33 through
the first incision 47 moves fluids 71 through the hollow fluid
passage 35 and into the receptacle 36.
Whereas the above descriptions describe a fluid 71 as a substance
such as blood, bile, pus, or other bodily liquid, it is conceivable
that other materials may be considered as liquids or fluids in
certain situations. For example, morcellated tissue is of a
paste-like consistency and can be made to flow (like a fluid)
within a confined container with pressure. Additionally, pieces of
other solid or semisolid materials (such as tissue or dry
substances) can be made to move in a more fluid-like manner when
combined with a fluid 71, which acts as a lubricant. Thus, the
addition of a fluid 71 such as saline, water, (or any one of a
number of other liquids) to the improved specimen retrieval bag 25
can aid in the movement of tissue within the bag. Thus the fluids
71 described above can encompass a much wider range of materials
than those listed above, including morcellated tissue, and in some
cases, larger pieces of tissue.
While preferred embodiments of the present invention have been
shown and described herein, it will be obvious to those skilled in
the art that such embodiments are provided by way of example only.
Numerous variations, changes, and substitutions will now occur to
those skilled in the art without departing from the invention.
Accordingly, it is intended that the invention be limited only by
the spirit and scope of the appended claims.
* * * * *